also reported that vaccination of average-risk school-age children with such a vaccine would be cost-effective. The cost would be about $18,000 per QALY gained. Massad et al. (2009), on the basis of HCV incidence data for Sao Paolo, Brazil, calculated that a 100% effective hepatitis C vaccine that provides lifelong immunity and costs $300 per dose would cost $748,991 per death averted. If only high-risk people (for example, IDUs) were vaccinated, the cost would be $131,305 per death averted. If the hepatitis C vaccine had only 80% efficacy and lifelong duration, it would cost $242,667 per death averted if given only to high-risk people.

The committee recognizes the need for a safe, effective, and affordable hepatitis C vaccine. Such a vaccine could substantially enhance hepatitis C prevention efforts.

Recommendation 4-7. Studies to develop a vaccine to prevent chronic hepatitis C virus infection should continue.

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